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PRIVACY STATEMENT This Notice Describes How Medical Information About You May Be Used And Disclosed And How You Can Get Access To This Information. Please Review It Carefully. Protecting the privacy of information about your medical conditions and health is a responsibility LifeCare Medical Center, Inc. (LifeCare) takes very seriously. We understand that medical information about you and your health is personal and it is important to you that we keep it confidential. Staff members are committed to the practices and procedures we have established to protect the confidential nature of information about your health. This notice describes the ways in which we may use and disclose information about your health to carry out treatment, payment and health care operations, and for other purposes as permitted or required by law. It also describes your rights and our duties regarding the use and disclosure of protected health information. Uses and Disclosures of Information About Your Health WITHOUT Your Authorization The following categories describe different ways that we may use and disclose information about your health without your written authorization. For each category, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information without written authorization fall within one of the categories. Treatment: We may use information about your health to provide you with medical treatment and/or related services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other LifeCare personnel who are involved in taking care of you at LifeCare. Different departments of LifeCare also may share medical information about you in order to coordinate other services you may need, such as prescriptions, lab work and x-rays. We may also disclose medical information about you to people outside LifeCare who may be involved in your medical care after you leave LifeCare. Payment: We may use and disclose your health information so that the treatment and services you receive at LifeCare can be billed for and payment can be collected. For example, we may need to give your health plan information about surgery you received at the hospital so your health plan will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. Health Care Operations: We may use and disclose your health information for our organization operations. These uses and disclosures are necessary to make sure that all of our patients/residents/clients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many hospital patients to decide what additional services LifeCare should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information about your health to our business associates to enable them to perform services for us or on our behalf relating to our operations. Hospital Directory: We may include certain limited information about you in the hospital directory while you are a patient at the hospital. This information may include your name, location in the hospital, your general condition (i.e. fair, stable, etc.) and your religious affiliation. The directory information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or minister, even if they don’t ask for you by name. This is so your family, friends and clergy can visit you in the hospital and generally know how you are doing. Correctional Institutions: If you are an inmate, we may disclose your health information to your correctional facility to help provide you health care or to provide safety to you or others. Law Enforcement: We may release your health information if asked to do so by a law enforcement official. For example, disclosures may be made in response to a warrant or subpoena; for the purpose of identifying or locating a suspect, witness or missing persons; or to provide information concerning victims of crimes. Coroners, Medical Examiners and Funeral Directors: We may release your health information to a coroner or medical examiner during their investigations. We may also release health information to funeral directors so that they may carry out their duties. We may disclose personal health information to organizations that handle donations of organs, eyes or tissue and transplantations. Public Health Issues: We may disclose your health information to an authorized public health authority for public health activities in controlling disease, injury or disability. For example, we may disclose your personal health information to the childhood immunization registry. Health Oversight Activities: We may disclose your health information to a government agency authorized to conduct health care system or governmental procedures such as audits, examinations, investigations, inspections and licensure activity for public health activities. Legal Proceedings: We may disclose your health information in the course of any legal proceeding, in response to a court order or administrative judge and in certain cases, in response to a subpoena, discovery request or other lawful process. To Prevent a Serious Threat to Health or Safety: We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Military Activity & National Security: We may disclose your health information to armed forces personnel under certain circumstances and to authorized federal officials for national security and intelligence activities. Workers’ Compensation: We may disclose your health information as required by workers’ compensation laws. As Required by Law: We may use or disclose your personal health information when required to do so by federal, state (MN statute 144.45, Subd.5a) or local law. Uses and Disclosures of Information About Your Health WITH Your Authorization Other uses or disclosures of protected health information that are not described in this notice or are not otherwise permitted by law will be made only with your written authorization. You may revoke such authorization as described in this notice. Your Rights Regarding Information About Your Health You have the following rights regarding the health information we maintain about you, which you may exercise by submitting your request in writing to: Privacy Officer LifeCare Medical Center, Inc. 715 Delmore Drive Roseau, MN 56751 mprachar@lifecaremc.org Right to Revoke Authorization: You may revoke your authorization (in writing) at any time, as provided by law. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are still required to retain our records relating to the care we have provided to you. Right to Request Restrictions: You have the right to request a restriction or limitation on certain uses/disclosures of protected health information for treatment, payment or health care operations. The law, however, does not require us to agree to these restrictions. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment. In your written request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse. Right to Request Confidential Communications: You have the right to request (in writing) that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your written request must specify how or where you wish to be contacted. Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Your request may be denied if the provider has determined that the information is detrimental to the physical health of the patient, or is likely to cause the patient to inflict self harm or to harm another. If you are denied access to medical information, you may request that the denial be reviewed. We will comply with the outcome of the review. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us (in writing) to amend the information. In your written request, you must also provide a reason that supports your request. You have the right to request an amendment for as long as the information is kept by or for LifeCare. We may deny your request if you ask us to amend records that: -were not created by us; -are not part of the medical information kept by or for LifeCare; -are determined to be accurate and complete. Right to Request an Accounting: You have the right to request (in writing) information about the times we have disclosed your personal health information for any purpose other than the following exceptions: -Treatment, payment or health care operations -Disclosures that you or your personal representative have authorized. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Right to a Copy of this Notice: You have the right to obtain a copy of this notice at any time. You may obtain a copy of this notice at our website, www.LifeCarenc.com or by submitting your request to the contact listed below. Our Duties Regarding Information About Your Health We are required by law to: -Maintain the privacy of information about your health; -Provide you with this notice of our legal duties and health information privacy practices; and -Abide by the terms of this notice. Changes to this Notice We reserve our right to change the terms of this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the hospital and nursing homes. In addition, each time you register at or are admitted to the hospital for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current notice in effect. If you are receiving home care or hospice services, a current notice will be made available. For More Information or to File a Complaint If you believe your privacy rights have been violated, you may either: 1.) Call us at (218) 463-2500. 2.) File a written complaint with our privacy officer. 715 Delmore Drive Roseau, MN 56751 3.) Notify the Secretary of the U.S. Department of Health & Human Services (DHHS) by sending your complaint to: Medical Privacy Complaint Division Office for Civil Rights U.S. DHHS 200 Independence Avenue, SW Room 509F, HHH Building Washington, DC 20201 Please be assured that you will not be retaliated against for filing a complaint about our privacy practices either with us or DHHS. Contact Person: If you have questions, complaints or would like additional information, please contact: Privacy Officer 715 Delmore Drive Roseau, MN 56751 (218) 463-2500 mprachar@lifecaremc.org This notice was published and became effective on April 14, 2003. |
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